Tramadol is an opioid non-narcotic analgesic drug having the chemical name of trans-(.+-.)-2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol and has heretofore been used broadly in the form of hydrochloride for the management of intense to moderate pain.
Urinary incontinence is a disease generally considered to occur when the intravesical pressure involuntarily exceeds the urethral closure pressure and is suspected to involve, as an etiologic factor, an increase in intravesical pressure (which chiefly causes urge urinary incontinence or urinary frequency) or a decrease in urethral closure pressure (which chiefly causes stress urinary incontinence).
The current pharmacotherapeutic regimen in urinary frequency or urinary incontinence includes the drugs adapted to lower intravesical pressure, i.e. decrease the contractility of the detrusor muscle, such as anticholinergic drugs (e.g. oxybutynin, propiverine), tricyclic antidepressants (e.g. imipramine), smooth muscle direct relaxants (e.g. flavoxate), etc., and the drugs adapted to increase the urethral closure pressure, i.e. increase the resistance of bladder neck or the urethra, such as .alpha.-adrenergic agonists (e.g. ephedrine), .beta.-adrenergic agonists (e.g. clenbuterol) and female hormones (e.g. estradiol). Opioid analgesics are not included in this therapeutic regimen.
Up to the present, there is no report indicating that any drug belonging to the established and clinically accepted class of opioid analgesics, represented by morphine, is ever effective in the treatment of urinary frequency or urinary incontinence. In addition, as to tramadol, it is not known at all that, as a main efficacy, this drug is effective in the therapy of urinary frequency or urinary incontinence.